Continuous Hemofiltration in the Treatment of Acute Renal Failure

Forni, Lui G.; Hilton, P. J.

doi:10.1056/nejm199705013361807

Cited by 199 publications

(107 citation statements)

References 17 publications

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“…Continuous renal replacement therapy (CRRT), including continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodiafiltration (CVVHDF), is frequently used as an alternative to conventional hemodialysis in critically ill patients with acute renal failure (9,15). However, relatively few clinical data are available regarding the removal of commonly used drugs during CRRT.…”

mentioning

confidence: 99%

Pharmacokinetics of Levofloxacin and Ciprofloxacin during Continuous Renal Replacement Therapy in Critically Ill Patients

Malone

Fish

Abraham

et al. 2001

Antimicrob Agents Chemother

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The pharmacokinetics of intravenously administered levofloxacin and ciprofloxacin were studied in intensive care unit patients during continuous venovenous hemofiltration (CVVH; four patients received levofloxacin, and five received ciprofloxacin) or hemodiafiltration (CVVHDF; six patients received levofloxacin, and five received ciprofloxacin). Levofloxacin clearance was substantially increased during both CVVH and CVVHDF, while ciprofloxacin clearance was affected less. The results of this study suggest that doses of levofloxacin of 250 mg/day and ciprofloxacin of 400 mg/day are sufficient to maintain effective drug concentrations in the plasma of patients undergoing CVVH or CVVHDF.

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mentioning

confidence: 99%

Pharmacokinetics of Levofloxacin and Ciprofloxacin during Continuous Renal Replacement Therapy in Critically Ill Patients

Malone

Fish

Abraham

et al. 2001

Antimicrob Agents Chemother

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show abstract

“…For RRT, indications were listed as follows: PO-AKI with nonobstructive oliguria (urine output <400 mL/day) or urine output <20 mL/h, systemic inflammation reaction syndrome (SIRS), septicemia, sepsis, CHF and pulmonary edema with unstable circulation, brain edema, acute respiratory distress syndrome that depended on mechanical ventilations, acute necrotizing pancreatitis, high catabolism, hepatic encephalopathy, requirement of intravenous nutrition support, MODS, hyperbilirubinemia, and lactic acidosis. [17][18][19][20] Different types of RRT including continuous veno-venous hemofiltration (CVVHF) or continuous veno-venous hemodiafiltration (CVVHDF) were performed according to patients' clinical situations.…”

Section: Treatmentmentioning

confidence: 99%

Analyzing Chinese Patients with Post-Operative Acute Kidney Injury

et al. 2011

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Background: To investigate clinical characteristics and risk factors of Chinese patients with post-operative acute kidney injury (PO-AKI). Methods: Patients with PO-AKI in Ruijin Hospital from December 1997 to December 2005 were retrospectively studied. Results: Patients' mean age was 62.2 ± 18.1 years. There were 111 males and 57 females. The mean serum creatinine at diagnosis was 370.41 ± 320.92 µmol/L and the mean estimated glomerular filtration rate was 33.56 ± 24.24 mL/min. For the outcome of the patients, 38 died and the mortality rate was 22.6%. There were 17 patients (10.1%) with Acute Dialysis Quality Initiative-RIFLE (risk-injury-failure-loss-end classification) phase R, 21 (12.5%) with phase I, and 130 (77.4%) with phase F. There was no significant difference in mortality regarding patients who underwent different types of surgeries. For the risk factors related to PO-AKI, acute tubular necrosis (ATN) increased relative risk of mortality PO-AKI (odds ratio = 7.089, 95% confidence interval = 2.069-24.288, p < 0.001). Multivariate regression models showed that ATN had a positive correlation with mortality of PO-AKI. Conclusions: PO-AKI is one of the most common causes of AKI in patients who underwent operations. Special attention should be paid to risk factors related to PO-AKI in order to improve prognosis.

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“…Daily hemodialysis or continuous hemodialysis/hemofiltration will correct the fluid and electrolyte abnormalities that accompany rhabdomyolysis and renal failure. Continuous hemodialysis and hemofiltration do not cause hypotension and cardiac arrhythmias that are associated with the rapid fluid shifts that occur with intermittent hemodialysis [91]. This may make these modalities more appropriate in critically ill patients with hemodynamic instability.…”

Section: Treatment Of Arfmentioning

confidence: 99%

Crush injury and rhabdomyolysis

Malinoski

Slater

Mullins

2004

Critical Care Clinics

215

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Although clinical syndromes consistent with rhabdomyolysis were recognized in the late 19th and early 20th centuries, the modern history of the crush syndrome begins with Bywaters' and Beal's classic description of the entrapped bombing victims of London during World War II [1 -4]. They reported five cases of crush injury, in which victims had one or more of their extremities trapped under debris for prolonged periods of time. All five patients presented in shock, had swollen extremities, developed dark urine, progressed to renal failure, and eventually died. Histologic examination of the kidney revealed tubular necrosis and pigmented casts. In 1944, Bywaters and Stead identified myoglobin as the urinary pigment and proposed its role in the development of renal failure [5].Large numbers of patients with crush injuries and rhabdomyolysis have been reported after the collapse of mines [6,7], severe beatings [8], and earthquakes [9 -15]. In the United States, alcohol intoxication associated with prolonged muscle compression and seizures is the most common etiology of rhabdomyolysis [16]. Serum creatine kinase (CK) levels correlate with the degree of muscle injury [14] and can be used to assess the severity of rhabdomyolysis. Acute renal failure (ARF) is one of the most serious consequences of rhabdomyolysis and occurs in 4% to 33% of cases, carrying with it a mortality rate of 3% to 50% [17]. Rhabdomyolysis accounts for 5% to 7% of all cases of ARF in the United States [18].This article focuses on the pathophysiology and treatment of myoglobinuric renal failure caused by traumatic rhabdomyolysis and crush injuries.

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Continuous Hemofiltration in the Treatment of Acute Renal Failure

Cited by 199 publications

References 17 publications

Pharmacokinetics of Levofloxacin and Ciprofloxacin during Continuous Renal Replacement Therapy in Critically Ill Patients

Pharmacokinetics of Levofloxacin and Ciprofloxacin during Continuous Renal Replacement Therapy in Critically Ill Patients

Analyzing Chinese Patients with Post-Operative Acute Kidney Injury

Crush injury and rhabdomyolysis

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